Many benefits managers exist within the realm of the insurance industry. With the multitude of benefits management options available to an insurance company, the question of who really benefits from this relationship arises. In the case of insurance companies administering claims involving claimant use of durable medical equipment (DME), a durable medical equipment benefits manager (DBM) has the ability to bring several positive changes to the insurance company and its claimants.
A DBM works with an insurance company to administer claims that include the use of durable medical equipment, prosthetics, orthotics and medical supplies (DMEPOS). The most common concerns for insurance companies with these types of claims include overall claims cost, claimant satisfaction levels and the quality of claimant care. Northwood is a highly trusted and experienced DBM that addresses these common concerns and offers additional advantages to the insurance companies it partners with.
The ever-increasing cost of DMEPOS claims can be mitigated through a variety of proven tactics implemented by Northwood. One such cost-saving measure centers around the provider network curated by Northwood over its more than two decades of experience as a benefits manager. More than 5,800 provider locations exist within this network that encompasses all of the United States in addition to Puerto Rico. Providers undergo a rigorous credentialing process in order to be accepted into the network and must participate in a re-credentialing process each year.
Insurance companies working with Northwood as their DBM will enjoy negotiated fee schedules that help reduce their claims costs. Claimants have access to the entire network as well and because of Northwood’s pre-authorization process on all DMEPOS claims do not need to pay out of pocket for medical services. This pre-authorization review allows Northwood to assure that all prescribed DMEPOS services are directly related to the claim and therefore necessary expenses to the insurance company.
Since Northwood reviews each provider request for injury relatedness and also ensures only the highest quality providers are accepted into its network, the level of accuracy within DMEPOS claims increases as well. Fewer errors and the elimination of non-injury related treatments and expenses also translates into an increase in the quality of care that claimants receive. These benefits therefore naturally raise the level of claimant satisfaction with DMEPOS claims.
After examining the top concerns of insurance companies administering DMEPOS claims, it is clear who actually benefits from benefits management. First and foremost, claimants realize significant improvements such as better quality of care because of a partnership with a DBM. Insurance companies also experience significant improvements due to the reduction of claims costs and the significant increase in claimant satisfaction levels.
For more information on partnering with Northwood as a benefits manager, please contact Rosanne Brugnoni at 586-755-3830 ext. 3771.
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